Thursday, April 13, 2006

Any Sympathy I Had Is Now Lost

I don't view the controversy over whether pharmacist can refuse to dispense Plan B and other like prescriptions because they have moral objections as cut and dry as many people do. Primarily, this is because I do generally believe that genuine conscientious objectors should get exemptions from generally applicable laws, statutes, or rules unless there is a compelling interest why they must be compelled to obey. I actually do think that forcing pharmacists to fill these prescriptions meets this burden, because often taking these pills is time-critical and other times it may be necessary for a woman's life or health. Given that you can't guarantee that another pharmacist will be on call or that another pharmacy will be nearby, I think there is a valid compelling interest that overrides individual conscience. But, as I said, that conclusion isn't a given from my perspective.

However, the surest way to lose my support on an issue like this is to take the principle to utterly absurd conclusions that appear to be far more motivated by animus against woman's health clinics than objections to abortion. For example, refusing to dispense non-abortion related prescriptions because the source was a clinic that, among other things, performs abortions (links:
Bitch, Ph.D and Prettier than Napoleon). That stretches way beyond any conceivable claim of conscience--even if I thought that the right of conscience extended to not dispensing emergency contraception, there is no way the claim goes so far as to allow the general refusal to dispense prescriptions from certain doctors or clinics who also participate in morally objectionable behavior. That stretches the logical line well past its breaking point.

I always try to give folks the benefit of the doubt in heated controversies, but honestly, sometimes y'all make it hard....


Mark said...

I'm not sure you're being honest here. You say this is going over the line ... but exactly how is it different other standard (my guess would be approved) activist practices which involve not patronizing a particular business because of their practices such as investment strategies, i.e., South African or Israeli firms.

In both cases (this case and the objection to investments), the conscientious objection/activism is applied because of objectional actions taken by an indirect party (another example might be, not buying Nestle products (harming the local retailer) because Nestle sell particular products in Africa)).

How is that different from causing these women to go to Walgreen, Osco, or whatever other nearby alternative pharmacies are locally available. To show "harm" or "unconscionable objection" in this case I think you have to demonstrate that the Swedish Medical Center outpatient pharmacy was the only pharmacy available in Seattle (which I think is unlikely).

I think you have never really granted a moral right to conscientious objection when "extended to not dispensing emergency contraception" as you stated. For if you feel that the refusal to dispense means that the patient has no alternative you might reconsider, because fact that is certainly not the case, in that there are in fact many other pharmacies which would be happy to fill the prescription.

Like the recent Borders magazine kerfuffle, wherin some bloggers claimed this is censorship, when in fact it is not because there are many other outlets (including online) from which the magazine could be obtained. Those bloggers may be right in protesting Border's actions (as you might in in the pharmacists), but to say it is censorship (or refusal to provide access to emergency medicine) is incorrect.

David Schraub said...

The boycott analogy is really bad. Neither countries nor corporations have any legal or moral claim to my patronage. A customer, however, does have moral (and generally legal) claim to be serviced by an open business establishment that purports to be offering a desired service, which a pharmacist has to respect. And the pharmacist has another obligation to the company she works for--that company is being deprived of a paying customer (and risking alot of bad PR) due to the non-endorsed actions of a employee. The existence of external obligation to other parties doesn't exist in the boycott example. That's a MASSIVE difference.

I should add, then, that the company might choose not to offer emergency contraception as a categorical policy (for example, if it was owned by Catholics). That's a different scenario, because the customer doesn't have an assumption of reliance that the medicine will be there. It's not cut-and-dry either, because the state could reasonably say that access to emergency contraception is an overriding interest and find that there are enough locations where one pharmacy has a local monopoly that it needs to be made available. But that's a wildly different scenario. This is a case of an employee objecting personally, not corporate policy.

As for the existence of other pharmacies, first of all, in Seattle that might be true, but not every place is Seattle--I don't think you can assume massive competition everywhere. What about a small town in eastern Washington? Second, the permutation problem: how do we know the next pharmacy doesn't have a similarly oriented pharmacist? Third, time: again, Morning-after pills need to be taken as soon as possible. Driving across town and waiting for a prescription to be filled at another pharmacy could easily be differnce-making. Fourth, even if it just causes an inconvienance, employees of a store have a general obligation to do their jobs. Not filling out a vitamin prescription because of its source is a far cry from not filling emergency contraception. I'm just not convinced the "conscientious objection" is particularly compelling when the topic is anti-biotics. What if I objected to filling any prescription by a major pharmaceutical, on the grounds that they were immorally withholding AIDS medication from poor Africans (or, heaven help you, a radical Christian Scientist who thinks that medical treatment itself is immoral)? That might be a legitimate position to take, but I think I'm not really doing my job anymore and should probably seek other employment.

Anonymous said...

If people can not fill a prescription because of what clinic it came out of, can ambulance drivers refuse to take a heart attack victim to a particular hospital because they perform surgical procedures the driver finds not to her/his religious beliefs? What if the patient dies? Does the drivers 'morality' trump the patients right to life?

Can fire fighters refuse to save someone from a burning house if the Star of David is displayed prominanty somewhere on/in the house?

Can the local authorities refuse to investigate the church burnings in the south because they are Evangelical Christian Churches and the cops are Catholic?

Mark said...

You missed the point I was trying to make on the boycott. Yes, the company you patronize has no moral claim to your patronage, but by boycotting you harm the small retailer more than you harm the target (the Manufacturer) which is what I was trying to compare. That the agent most harmed (the retailer or the patient) is indirectly connected to the agent you are protesting (the manufacturer or clinic).

Let's try another analogy. Imagine that instead of abortions the clinic in question was performing involuntary sterilization of particular subsection of society (Jews, Illegal Immigrants, Blacks, whatever). The phamacist refuses to honor any prescriptions from that clinic on moral grounds because he/she feels that would be enabling the activities of that clinic. Would you complain? If you still would, I'll grant the honesty of your point. If not, then what is really at issue is that you only grant the conscientious objector the right to object when you agree with the principle over which he objects, which isn't exactly honest.

And on your last point, certainly (as this isn't France) the company has every right to terminate the pharmacist if they disagree with his activism.